Would lifting the ban on drugs enhance sport?

When the world’s fastest runners take their marks for the 100 metre Olympic final this weekend, how many will owe their place to performance enhancing drugs?

According to Professor Werner Franke, half of the men’s 100m finalists from the previous two Olympic Games were later reported to have used banned substances. Does it matter? Were those athletes risking their health? Was the ‘spirit of sport’ being betrayed? Is the ban on drugs worth keeping if half the competitors flout it anyway?

Franke is a German cell biologist who has become a leading expert on, critic of and campaigner against doping in athletics. In a session called ‘Building a better athlete?’ at last month’s Euroscience Open Forum in Dublin, he discussed the current state of doping in athletics. He was followed by Professor Julian Savulescu, director of the Oxford Uehiro Centre for Practical Ethics, who agreed that drug use is rife in professional sport but disagreed over the response.

“No weasel words”

In 1991, Franke’s wife, former West German Olympic discus thrower Brigitte Berendonk, published a book called Doping: From research to deceit. Since then, they have both campaigned against the use of performance-enhancing drugs in sport. He doesn’t like the phrase “performance enhancing drugs’, mind you – he just calls them “drugs” because that’s what they are.

The use of steroids for improving athletes’ performance began in the 1960s. At this time, said Franke, “a person who did not take steroids could not dream of competing.”

In East Germany, the practice was disguised in official records as ‘vitamin injections’. However, the truth came to light several decades later, long after suspicions were first raised. Franke said we were lucky that the systematic doping regime was based in Prussia, “where the scientists take very detailed lab notes”, otherwise we might never have had proof of what was happening.

Today, of course, claims around drug use continue. Franke described numerous cases that he said he shouldn’t really be telling us about because of various court orders against him. But he was adamant the evidence is there and that he will be proved right eventually.

There were hair-raising accounts of the kinds of tricks used by athletes to produce clean urine samples after events, some of which were reminiscent of the Whizzinator, currently on display in Wellcome Collection’s Superhuman exhibition.

As for other banned drugs claimed to be in use in athletics today, aromatase inhibitors are “prevalent”, Franke explained, because they prevent the body’s natural process of turning androgens into oestrogens, raising the amount of hormones like testosterone without having to inject them directly. He also mentioned IGF-1 (insulin-like growth factor) and EPO (erythropoietin).

“Safe doping”

Savulescu said there are many reasons to ban doping agents. Some are valid, such as concerns over safety or that they are against the spirit of sport. However, he claimed the argument that they enhance performance is not valid, but arbitrary and inconsistent with other, permitted training techniques.

“We are not horses,” he said. “Races do not just test our natural ability.”

He pointed out many inconsistencies in the current rules:

Natural genetic mutations that give you an advantage are ok, genetic engineering would not be;

Drugs to treat injuries are ok, drugs for enhancement would not be;

Altitude training is ok, oxygen tents are ok, EPO is not, despite the fact it has exactly the same physiological effect;

The flaw of the ban, said Savulescu, is that we encourage athletes to do everything necessary to win gold – enormous physical effort stretching the limits of the human body, training long hours, making sacrifices in their personal lives – yet have introduced an artificial limit prohibiting what seems like a natural next step, such as enhancing your training programme by using steroids or EPO. We applaud athletes for going the extra mile in pursuit of victory, but one step too far turns them into pariahs.

The ban on drugs is just a rule, however, and like all rules it is subject to change. For example, caffeine was taken off the International Olympic Committee’s banned list in 2004. Sports change their rules for many reasons, such as to improve safety or to increase entertainment or revenues. Savulescu’s argument, therefore, is that we should just change the rules to allow safe doping. Then we wouldn’t have to worry about who was breaking the rules any more, but could put the emphasis on athletes’ health instead.

Take EPO as an example. Athletes are already monitored for their haematocrit levels – the percentage of their blood volume made up by red blood cells. EPO is used to increase haematocrit, just like using an oxygen tent or training at high altitude. More red blood cells means more oxygen carried from the lungs to the muscles, meaning better performance, particularly in endurance events.

Instead of monitoring haematocrit as a way of catching EPO users, Savulescu suggests it should be measured before events only to safeguard athletes’ health. Regardless of the method used to raise haematocrit, they would be allowed to compete as long as it was not above a certain unsafe level.

So enhancing performance should be allowed by whatever means, as long as it is safe, because this is what we already ask of athletes.

The remaining valid reason for banning drugs was the ‘spirit of sport’. Savulescu addressed this too: he explained that professional musicians regularly take beta blockers to enhance their performance in concerts and this is not considered to be against the ‘spirit of music’.

He sees no difference in sport, although he would not permit the use of beta blockers in snooker or archery to stop the head or hands shaking, for example, because that is an integral part of what the sport is testing in its participants. So the rules around drug use would have to be made on a sport-by-sport basis.

Finishing line

“Cheating is ruining sport,” Savulescu concluded. His answer? Change the definition of cheating. He says the ‘war on drugs’ is bound to fail because the rewards for winning are so high that they outweigh the risk of getting caught. It would be better to regulate the use of drugs in sport so that they are safe for the athletes and consistent with their other training options.

I’m not sure he persuaded Franke, who will continue to fight against drugs in sport, primarily on health grounds. He said the risks are too high, especially if the use of drugs in sport might then spread to younger people, even children.

Savulescu agreed that drugs should not be given to children but he pointed out that many sports are dangerous and many athletes already risk their health for sport. Widespread use of EPO would not lead to anything like the damage risked in contact sports like rugby, or even in track and field events, where injuries are commonplace.

It would be one more technique at athletes’ disposal to get their best possible performance, whether they were aiming to be faster, higher or stronger.

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